Educational Approaches for ADHD
Whether stimulant medication is administered or not, the classroom teacher still needs to improve the achievement of students and help them learn to cope with some of the deleterious outcomes associated with hyperactivity, distractibility, and impulsivity. What follows is a brief synopsis of educational strategies used by general and special education teachers to help students with ADHD .
- Cognitive Behavior Modification (CBM). The objective of CBM is to teach students problem-solving strategies and self-control techniques. Students are instructed in a step-by-step procedure to monitor and direct their behavior. For example, students are taught to deal with conflict by (1) calming down before reacting impulsively; (2) identifying feelings and expressing feelings in an appropriate manner; (3) setting positive goals for themselves; (4) thinking of alternative solutions to problems; (5) trying a plan and evaluating results (Greenberg, 1998). The overall goal is for students to spontaneously think through situations in which they feel the impulse to act quickly.
- Social Skills Training. Students with ADHD develop impulsive habits that interfere with their ability to manage interactions with peers and adults. The purpose of social skills training is to rectify social skills deficits through direct and indirect instruction. This proactive approach seeks to change students' disruptive behavior by focusing on teaching new skills rather than the reactive approach of trying to eliminate bothersome behaviors. For example, a student who acts out impulsively might benefit from learning to verbalize his or her feelings (i.e., proactive), rather than being sent to timeout each time the offending behavior occurs (i.e., reactive). Social skills curriculums employ a variety of instructional techniques including modeling, step-by-step scripts, classroom meetings, reinforcement, and emphasizing social skills embedded in the regular curriculum; for example, using science to teach how to anticipate consequences or using children's literature to teach conflict resolution.
- Contingency Management. Based on principles of behaviorism, students are rewarded when they demonstrate socially appropriate behavior. Contingencies also can include negative consequences for inappropriate behavior. Positive consequences can include praise or tangible rewards. Reprimands or ignoring the behavior are examples of frequently used negative consequences. Teachers must be vigilant to ensure that negative consequences are logical and match the inappropriate behavior. For example, a logical consequence for throwing food in the cafeteria is eating lunch alone in the classroom for 3 days rather than doing additional homework. Other applications of behavior theory to ADHD include token economy, response cost, and contingency contracting.
- Structured Activity and Movement. Planned classroom activities that allow students to move about, converse with others, and interact with concrete materials help students with ADHD sustain attention and reduces the stress of trying to constantly restrain motor activity. Some frequently used techniques are learning centers, planned student interactions, art, music, kinesthetic activity, games, and authentic learning experiences such as teaching ratios by making orange juice from concentrate (Reif, 1998).
- Self-Management Strategies. Students with ADHD lack organizational skills for sustaining attention and completing projects. Direct instruction in time management helps students learn to divide a task into subunits. By monitoring due dates incrementally, teachers help students set realistic time lines and avoid procrastination. Helping students learn how to organize materials is another key self-management strategy. Filing papers, scheduling, keeping notes in binders, and periodical inventory of materials are frequent self-management organizational objectives. Teaching study skills such as active reading (i.e., writing down questions and comments rather than simply highlighting), webbing of chapters, reviewing key topics and subtopics, and developing test taking skills are helpful strategies.
- Classroom Accommodations. The physical layout of a classroom is the single most important element in focusing attention. Textbooks with shiny paper particularly are problematic under fluorescent lights. Also, the hum and the flickering of fluorescent lights is a distraction and they should be replaced with incandescent lights. Soft, classical music in the background can be soothing. "Natural" sound recordings can have a similar effect. Student seating should be adjusted to cut down distractions from high-traffic areas. Sitting at tables may present a problem for some students. Canels with side panels help eliminate visual distractions. Some teachers report that overhead projectors help cut down on visual distractions by reducing the "clutter" that sometimes fills up chalkboards (Flick, 1998). Directions should be given slowly with frequent requests for the student to provide restatements. When worksheets are used, students benefit from fewer problems to complete, lined paper helps with handwriting, and computer software offers myriad possibilities from word processing to games that reinforce academic skills.
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